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NICK GINA 14050006 KNOWLEDGE MOKOENA 14103045 MOFFAT NDABADIME 14130506 SEAN GOTA 14107784 BONGANI LUKHELE 12021700 NAWAAZ OMAR 13046765 2016 Heart FailureGroup 54 Heart Failure Heart Failure(HF) is a major worldwide public health problem It is a clinical syndrome in which structural or functional cardiac conditions impair cardiac output to the rest of the body at rest or with exertion1 Heart Failure (cont’d) Abnormal heart structures: Left Ventricular Hypertrophy 2 Ventricular Septal Defect3 Heart Failure (cont’d) In the US alone, 1 in 5 people over 40 years of age will develop heart failure during their lifetime1 HF is also the leading cause for hospitalization in the elderly However, HF survival has improved and thus the number of sufferers over 65 is increasing1 Heart Failure (cont’d) In younger age groups (patients under 50 years) heart failure is more common in males The main causes of Heart Failure are1: Hypertension Ischaemic Heart Disease Valvular Heart Disease Myocardial Infarction Other Cardiomyopathies In the elderly, prevalence of Heart Failure is equal between both sexes Typical Signs & Symptoms of Heart Failure1 Dyspnoea at rest or during exercise Pleural Effusion Raised Jugular Venous Pressure Hepatomegaly Fatigue Orthopnoea Peripheral Oedema Pulmonary Rales Morbidity and Mortality Heart failure and coronary artery diseases are currently on the rise in the African region. Heart failure has become a major public health problem especially in Sub Saharan states. One reason for the most recent rises in heart failure is the aging population in the region. There were approximately 80 million adults with hypertension which is a causative condition for heart failure in the year 2012 and the figure is expected to double by the year 2025.4 Morbidity and Mortality (cont’d) Out of the 16 million deaths under the age of 70 due to non-communicable diseases, 37% is due to heart failure.4 At least three quarters of the world’s deaths from heart failure occur in low and middle income countries. The major causes of cardiovascular disease are the smoking of tobacco, a lack of physical activity, an unhealthy diet and alcohol abuse. 4 out of 5 deaths due to CVD are due to heart failure and strokes 4 Disability The classic symptoms of heart failure include;4 Chest pain Shortness of breath Orthopnea Swelling of limbs, including both legs and feet General discomfort of the gut Pale, clammy and cold extremities Disability (cont’d) These symptoms of heart failure amongst others lead to disability. Heart failure has an impact on individual’s families and overall society in terms of health care costs as well absenteeism Descriptive Epidemiology for Heart Failure i.e. Who, when, where and by how much? Who? Hypertensive patients Male patients Studies have proven that CHF patients in more occasions than not had antecedent hypertension 4 Surprisingly enough males are more predisposed to HF than females4 Elderly patients Incidence rates of CHF rose markedly with age 4 When? Age (incidence rates of CHF rose markedly with age) 4 as presented by the graph below: Where? • Poor regions of the world: (4 of every 5 deaths globally from cardiovascular disease occurred in developing nations )1 How Much? Per Gender: The population-attributed risk for cardiac heart failure with an antecedent hypertension is nearly 40% for males and 60% for females Per socio-economic status : i. 4 out of every 5 global deaths from cardiovascular disease occurred in developing nations.4 ii. 45 % of global acute heart failure cases are in Sub-Saharan Africa.4 Predisposing illnesses: 90% of Framingham participants who developed CHF had antecedent hypertension. Levels of Prevention The nature of heart failure prevention is mostly directed on secondary prevention and treatment in patients who resemble signs of heart failure5. The levels of prevention are divided into three categories, namely; Primary prevention Secondary prevention Tertiary prevention Primary Prevention Primary prevention are methods of preventing heart failure before an individual who is at high risk can have it. This is achieved through combating the main causes of heart failure such as; 6 exercising regularly Eating a balanced diet Reducing alcohol consumption Cessation of smoking Education on healthy habits is also a good weapon of primary prevention. Secondary Prevention Secondary prevention focuses on minimising the effects of heart failure. The focus is on detecting and treating heart failure and preventing it from occurring again. Treatment strategies include a combination of medication like: Angiotensin converting enzyme (ACE) inhibitors Diuretics Aldosterone antagonists Secondary Prevention (cont’d) A surgical procedure is also an option which is used in treating heart failure. The aim of a surgical procedure is to stop any further damages to the heart and improve the function of the heart. Bypass surgery, heart valve surgery and heart transplants are some of the many examples of surgical procedures performed in heart failure. Tertiary Prevention The goal of tertiary prevention is to alleviate the impact of heart failure, since heart failure is a chronic disease that requires lifelong management. This involves taking care of the heart and making follow up exams. References 1. C. Sinescu, L. Axente. “Heart Failure- concepts and significance. Birth of a prognostic model”. Journal of Medicine and Life. 2010 Nov 15; 3(4): pg 421-429. Published online 2010 Nov 25. Carol Davilla University Press. 2. US Heart Specialist [Internet]. Types of Heart Diseases. [updated 2010 Aug 30; cited 2016 Jan 27]. Available from: http://usheartspecialist.blogspot.co.za/p/types-of-heart-diseases_30.html 3. Raj Udupi [Internet]. Manipal doctors perform rare heart procedure. Udupi Today Media Network; [updated 2014 Aug 28; cited 2016 Jan 27]. Available from: http://www.udupitoday.com/udtoday/news_Manipal-doctors-perform-rare-heartprocedure_4416.html 4. Mahmood SS, Wang TJ. The Epidemiology of Congestive Heart Failure: Contributions from the Framingham Heart StudyN Engl J Med. 2013 Mar 25; 230(4):274-7. 5. Javed Butler, “Primary Prevention of Heart Failure,” ISRN Cardiology, vol. 2012, Article ID 982417, 15 pages, 2012. doi:10.5402/2012/982417 6. M. H. Murphy, S. N. Blair, and E. M. Murtagh, “Accumulated versus continuous exercise for health benefit: a review of empirical studies,” Sports Medicine, vol. 39, no. 1, pp. 29–43, 2009.